PPPSS News & Events

Reproductive Mental Health Resources

Article by Kelley Allen

I remember vividly a point during the worst of my Postpartum Depression and Anxiety with my first baby when I wanted to run out into the middle of the street yelling “Can somebody – anybody – please help me?!” I felt I was losing myself and couldn’t stay above the water, which was terrifying in and of itself, but adding in a young baby who depended on me for her each and every need made my chest feel so heavy I couldn’t breathe. I got online every chance I could to find counsellors, psychiatrists, family doctors, groups, really ANY ONE that might be able to help me. I left countless voice-mail messages reaching out for help. I knew I needed help but I had no idea where to go for that help. I felt completely and utterly helpless.

I am now pregnant with my second child and in an effort to prevent that feeling again, I recently I connected with Reproductive Mental Health at BC Women’s Hospital. Once I found out I was pregnant I asked my doctor to send a referral for me. The waitlist is LONG – my referral was sent late last summer and my appointment was just in January. I am not sure as to whether or not a referral can be any quicker. Perhaps mine was so long because I was so early in my pregnancy, but luckily I have been feeling quite good so far. As a lot of maternal depression and/or anxiety can start during pregnancy, it would be good to get more information from your doctor about how early you can be seen if you choose to get a referral to the RMH program. As far as I know, you do not have to give birth at BC Women’s Hospital in order to be referred to the program, but again double check that with your doctor.

I know going into this second birth and postpartum phase that I need to have this support in place, however I didn’t realize how much they had to offer until I went to the appointment. The first meeting was essentially talking with a psychiatrist who did an evaluation. Based on my answers, she gave me her advice on how to proceed with medication and support up to and following the birth. She was very thorough and extremely well informed about the medication that I have chosen to stay on during pregnancy, and was able to give me quite a bit of information about potential risks and side effects following birth. What I really appreciated was that she gave me the information, all of it – even the scary parts–while also remaining supportive. She explained the risks and percentages, while somehow not making it seem overwhelming. She also talked a lot about what supports I can line up now for the postpartum period and had many suggestions of things to look into and arrange prior to birth, which I found extremely helpful.

I think it is important to note that while I made the decision to stay on medication during pregnancy, I did not get the feeling that it was something that the clinic requires or even encourages by any means. There were a lot of aspects of treatment and self-care that were discussed that didn’t involve medication.

I will now be connected to Reproductive Mental Health for the remainder of my pregnancy (one month) and then for one year postpartum. The support provided can look many different ways; with phone calls to check-in assuming things are going well, to attending in-person meetings with the psychiatrist bi-weekly (or as her schedule allows). There is always an on-call psychiatrist as well, and participants are given the number should they be in crisis.

One of the things I didn’t realize was included are the groups and workshops available free of charge to RMH participants. I was given a sample booklet of topics, which included: Helping Baby Sleep, PPD/A Therapy Group, Cognitive Therapy, Self Esteem, Partnering and Self-Care, Bonding, Mommy Guilt, and Mindful Dads. These workshops are offered throughout the year, so if I am not able to make it to the next one scheduled, I know it will come around again later in the year. Also, a huge bonus is that some of them you can take your baby to, depending on his/her age. This is so wonderful for new moms who don’t have access to childcare.

There is something so very comforting about going into this birth and postpartum period knowing that I have this support. Even if I don’t end up needing to use it, the service is there, which makes me feel so much better. I hopefully won’t feel the need to run out into the street screaming for somebody, anybody to help me.

This time around I feel much better prepared. I have a better idea of what to look for, when to reach out for help, and what supports are available if I need them. I think that this particular support can be very useful for a lot of women experiencing PPD/A.

For more information on the clinic, here is their RMH Website

 

A note from the editor, Andrea Paterson:

I’m also part way through my second pregnancy after suffering severe PPD/A after the birth of my son. Reproductive Mental Health programs are available at many hospitals besides BC Women’s. I’m enrolled in the RMH program at Richmond hospital and have been having a very positive experience. I’ve had to wait four months to see a psychiatrist, but I have had access to a sociologist in the meantime who sees me monthly for a check in. She has been an amazing resource and has pointed me in the direction of a cognitive behavioural therapy course for pregnant women with anxiety and depression. All of these resources are free to anyone with a BC health care card. Be sure to check if your home hospital has a Reproductive Mental Health program. Even if the wait lists are long there may be resources you can access while you wait. The earlier you reach out, the better!

 

Having a Baby After PPD/A: First Trimester

A version of this article appeared on the  Amaranth Road Studio blog.

Article by Andrea Paterson

Image Copyright Andrea Paterson. 2015. www.andreapaterson.com

Image Copyright Andrea Paterson. 2015. www.andreapaterson.com

Oh how I feel like sinking into deep water. I want to be a floating thing, suspended, warm, like the growing fetus within me. Inside my body grows a tiny girl and I am reeling. It took me a long time to get here. After a serious and prolonged battle with postpartum depression and anxiety after the birth of my son in 2012 I have existed in a state of profound ambivalence when it came to the idea of another child. I was too close to too much suffering and the thought of being dragged back into the underworld of PPD/A sent me screaming for the hills. I avoided it, I put it off, I wrote about it at length in my journal and over the course of the past two years, the Ghost Baby took form.

The Ghost Baby was imaginary. Sort of. The Ghost Baby was the idea of another child made almost tangible in my imagination. I spoke to this apparition. She always appeared as a wise female infant with a cheeky and knowing smile.

“Should I open the door and let you into the world?” I would ask her, tears in my eyes, full of doubt. And she would smile at me, enigmatic, like some itsy bitsy Buddha. She clearly knew more about my future than I did. Her smile said, “things will be as they should be, and there’s very little you can do about it.” She asked me to let go, but I resisted. I saw her in my mind’s eye again and again, smiling serenely, waiting patiently for me to make up my mind.

It took a lot of soul searching, but eventually I decided that I wanted to let the Ghost Baby in. There were many reasons for this–I wanted a sibling for my son, my husband was desperate for another child, and if I was honest with myself I realized that my fear centered mostly on the pregnancy and first 2-3 years of the child’s life. It wasn’t so much that I was afraid to have another child, but that I was afraid to have another infant. Because infancy is the fifth circle of hell. Or at least it was the last time around. Even a mention of sleep deprivation can get me to have a full blown panic attack.

But I lived last time. Right? Right? And it seems to follow that I’ll survive this time too and get something awe inspiring out of it: a relationship with a human being that was once literally a part of me.

The Ghost Baby wasn’t goofing around. She took the very first opportunity to manifest herself. She wasn’t going to let me change my mind. It was practically a virgin conception. And so it was in a state of shock and disbelief that I stared at the plus sign on that first pregnancy test. Things were about to get real. And they did. By six weeks my worst fears were coming true. I developed Hyperemesis Gravidarum, the dreaded pregnancy illness that leaves women nauseous and vomiting to the point of weight loss and severe dehydration. I went to the hospital emergency three times before they finally admitted me and put me on an IV drip containing a cocktail of four different drugs. Three days later I was a different person. I got to go home with bags of prescriptions and I have spent the weeks since in a drug induced haze, sleeping nearly 12 hours a day, and scraping by.

The Ghost Baby, now just The Baby, who I am calling Button for now, smiles her knowing smile at me. “Yup, you’re going to have to endure some tough shit,” she says to me, “but LOOK, you’re surviving! And it’s going to be okay.” And I am surviving, for one reason: I called in every support I could think of. The local grandparents have been working serious overtime picking my son up from preschool and caring for him many days and afternoons while I lie in an ill heap. My mom was called in from Ontario when things were really bad after Christmas. She took over my entire household and I had two glorious weeks to gather strength. My husband is on evening and weekend duty. I’m taking care of myself in every conceivable way. Yeah, I still have Hyperemesis. But the drugs make it bearable and my support systems make it manageable. I am, against the odds, not depressed. Not thriving either maybe, but not headed straight for the pits of despair. In my first go-around as a pregnant mother I might have felt guilty about asking for so much help, I might have resisted because of that guilt. I might have thought that it’s better to go it alone and fend for myself. Not this time. No way. This time I refuse to give in to guilt because no one should have to face their journey to motherhood alone. I made a pact with myself to accept help where offered and assume that people were happy to be of service. A friend sent me a message asking if she could help, if she could pick up groceries or cook me some soups to put in my freezer. Last time I would have said, no, I’m fine, don’t worry. This time I said YES, YES freezer meals would make a huge difference for me. Two days later three huge batches of soup arrived at my door and it fed my husband for weeks while I was too sick to prepare meals and unwilling to eat anything but Boost shakes and pudding. That act of kindness saved me. It made a time that might have been unbearable into a time that we survived. My husband was fed and as such had more time to run other errands and care for our son. My gratitude is immense and I know that one day I’ll be able to pay it forward.

So my pregnancy goes on, and I let people around me act as life preservers. The baby becomes more real every day. An early genetic test revealed two things: My baby is healthy so far and my baby is a girl. The news that I have a daughter on the way struck me as unbelievable. The Ghost Baby I have been imagining is suddenly a flesh and blood person who has taken up residence in my womb. The little girl with the knowing smile will be in my arms this summer. And I’m thrilled of course, because it feels like my inner world just touched down in my physical lived experience. One boy, one girl and everything feels complete.

I’m still terrified about revisiting infancy, but my early pregnancy has taught me that there’s no shame in asking for help. Sorry grandparents. I’m probably going to need you a bit longer! And for now I’m depending on the wonderful world of medication to pull me through. Thank you modern science! Here’s hoping that the second trimester is a bit easier, for everyone’s sake.

New Beginnings

Erika Mitchell brings us a reflective story for the New Year.

After the chaos and emotional intensity of the holiday season I find January and February can be blue months. In December I am kept so busy traveling or organizing holiday gatherings or planning extravagant meals that the sudden return to normalcy can be a let down. January brings a return to routine, and with two small children I find myself longing for the extra hands that had been exasperating just a few weeks before. However, once settled into the old routine and schedules I feel a relief as well. The kids are easier to manage without the hype and excitement and misguided input by well meaning family members. Eating and sleeping slowly return to normal and there are fewer blood sugar crashes. I also look forward to longer days beginning to creep up on us.

Another benefit of starting off a new year is that after a few weeks of schedule disruption I have a perfect opportunity to create new habits and practices that will better serve the whole family. It is an excellent time to look at my routine and see where moments can be taken for mindfulness or self care. I can plan on enjoying my favorite brand of tea for 10 minutes every morning, or I can make a mental note to take 10 minutes at lunchtime to try out my new adult coloring book. I can let myself put dinner on the table 10 minutes later than normal and get outside for a short walk with my family when everyone is home for the day or I can get down on the floor with my kids and just play – giving myself permission to ignore the dishes, laundry and cleaning that are always demanding my attention.

A new year provides the opportunity to create positive behavioral changes that can hopefully lessen the effects of postpartum depression. A 2015 evolutionary psychology article by Jennifer Hahn-Holbrook and Martie Haselton poses the idea that postpartum depression is a ‘modern disease’. The authors describe a number of modern conditions that may predispose us to postpartum depression. These include diet, which is typically low in fish, low in omega-3’s and high in saturated fat, our busy schedules that leave little time for daily exercise, our low sun exposure resulting in chronic Vitamin D deficiency, the societal pressures surrounding breastfeeding and our isolated existences with little or no family support. These five conditions create a perfect storm resulting in high incidences of postpartum depression.  The article emphasizes that these areas need to be further researched specifically because some of them have simple solutions that may alleviate a lot of suffering.

What I found interesting in their discussion was that, if correct, simple lifestyle changes might make the difference between slipping deeper into depression or lowering overall risk.  Eating a more balanced diet that includes more fish and omega-3’s, being physically active whenever possible, taking a vitamin supplement and creating stronger family and friend connections likely won’t cure depression, but they are positive changes that can increase physical health and possibly put us on the road to recovery and prevent a relapse at this dark and contemplative time of year.

As I am writing this I am looking out at the soupy mix of wet snow and rain under the dark grey skies that are typical of this time of year on the west coast. My two young children are fighting over Christmas toys and it is very tempting to curl up under my blankets and just go back to sleep. But I can also see snowdrops poking their way through the slushy ground, a determined little hummingbird bravely avoiding the drips to get to the feeder and chickadees surrounding the little pine cone feeders we put out for them on Christmas eve. Their plucky courage is inspiring, so I am going to make myself a cup of tea, wrestle my kids into their wet gear and then we will all go out to search for signs of spring and the new beginnings they represent.

References:

Hahn-Holbrook, J., & Haselton, M. (2014). Is postpartum depression a disease of modern civilization?. Current Directions In Psychological Science, 23(6), 395-400. doi:10.1177/0963721414547736

Gifts for the Soul

 

Pacific Post Partum Support Society counsellor, Anna Chambers, shares three gifts that you can give yourself this holiday season.

 

  1. Courage to ask for what I need.

 

Often, one of the ongoing struggles for women is having the courage to ask for what we need. One of the myths mothers may buy into is the belief that we must provide for the needs of others first and ourselves last. It can take practice to consider what it is we do need and to ask in a way that is respectful. As a new mother I often wished for someone to just know what I needed and do it. Reality is that we have to clearly ask our partners, family, friends and children for what we need. It is not up to us to decide whether or not that person can help us.

 

  1. Fewer expectations.

 

Providing a fun, exciting and abundant holiday season is something that many mothers may feel is their job to provide. Cooking, cleaning, hosting and shopping can become overwhelming and we can end up running ourselves ragged. Coupled with these stresses may be certain expectations of what kind of holiday we believe we ought to be enjoying or that our children’s experience must be a particular way. I have had to learn to let go of the expectations of how I think the holidays ought to look like and remind myself that I do the best with what I have.

 

  1. Acknowledgment that this may be a difficult time.

 

For many people, the holiday season is a very lonely, challenging time. Loved ones may have passed, families may not be enjoying positive relationships and others may be struggling. Recognizing that sometimes the holiday season is difficult and seeking support from those who love us can help to acknowledge our emotion around it.

 

From Pacific Post Partum Support Society, we wish you a holiday season that provides opportunities for sharing what is most important with those you love most.

Holiday Wellness

holiday-candy-canes

Article by Hollie Hall,  Pacific Post Partum Support Society phone counsellor and group facilitator

 

This time of year can bring with it a whole mixed bag of emotions for new parents. Usually our call volume here at PPPSS goes up with the darker days. For many of us the negative feelings can be very hard to cope with. I’ve been asked to contribute to our blog by writing about some triggers and self-care ideas. This is a pretty easy job for me as I remember this time of year to be particularly hard when my girls were very young.

Triggers:

Christmas ads are all around us. On the television, magazines and even YouTube. They usually have the picture perfect scene: Mom and Dad look amazing, babies and children are well behaved, the turkey dinner is scrumptious with all the trimmings and everyone is getting along. No chaos. In the real world many of us find a great deal of pressure to buy the best toys and gifts for the family and to create a perfect family holiday. For me, this was a big trigger and tied into wanting to be a perfect mom to my girls and to keep everyone happy.  My kitchen wasn’t big enough to fit three adults, let alone be able to cook a full turkey dinner but I wanted to live up to the standards set by those picture perfect holiday cards.  I had two very well behaved children, thankfully. However, my anxiety was keeping me from feeling relaxed especially during the holiday season. Loss plays a big role as well. We are often missing our families that are not near us or the loved ones who have passed on. Whether it be hosting a party, dinner or even trying to fit into the “perfect” party dress, feelings of sadness, anxiety, frustration and even anger can arise. That is why self-care is especially important over the holidays. A short list of self-care ideas may help you to keep things in perspective over the next weeks.

Self-Care:

Pace yourself

Lower expectation (of yourself and others)

If you are shopping for gifts, try little bits at a time and maybe start earlier rather than later

Try to get enough sleep and exercise, if sleep is an issue, think of lying down and resting as a good rejuvenation.

Cherish your body…try to celebrate the changes. You grew your baby, what an amazing feat!

Don’t beat yourself up for over having one too many treats. This is a time to enjoy food.

Allow yourself to grieve the loss of a loved one or even the loss of your old self.

Most of all, congratulate yourself on the wonderful job you did having your baby and watching your little one grow. This is because of you.

Seek out support if you need to talk to someone. This could be a good friend or any one of us at PPPSS.

These are just a few self-care ideas that may help during the holidays, however, they can be used at any time of the year.

On behalf of all us here at PPPSS, I would like to wish you all the best of the holiday season.

Remember to take good care of yourselves!